A complete list of heart disease prevention methods

The core of heart disease prevention has never been achieved by taking a certain Internet celebrity heart-protecting health supplement or following the trend and doing a certain type of popular exercise. The essence is to combine one's own risk factors and make long-term personalized adjustments from four aspects: diet, exercise, chronic disease management and living habits. Current global evidence-based medicine data shows that adhering to a scientific prevention plan can reduce the risk of cardiovascular disease by 30% to 70%.

Last week, I met 62-year-old Uncle Zhang at a community free clinic. He was diagnosed with 30% coronary artery stenosis just after he retired. He asked me if I wanted to increase the dosage after searching the Internet for the prescription "One spoonful of Panax notoginseng powder a day to protect the heart." After careful questioning, I found out that he had smoked 20 cigarettes a day for 40 years and had never taken medicine for high blood pressure for five years.

Speaking of the heart-protecting diet that many people are concerned about, the most controversial topic on the Internet right now is whether the Mediterranean diet or the low-carb diet is more effective. The core of the Mediterranean diet currently promoted by the AHA (American Heart Association) is to eat more whole grains, fresh fruits and vegetables, use olive oil instead of animal oil, eat deep-sea fish once or twice a week, and eat less processed meat and desserts. I have an old patient next to me. His bad cholesterol (low-density lipoprotein) reached 4.2mmol/L before. After adhering to the Mediterranean diet for half a year, it was directly reduced to 2.8mmol/L. The effect is indeed obvious. However, recent studies have pointed out that for people with insulin resistance and usually high blood sugar, simply copying the Mediterranean diet template is not as effective as reducing the intake of refined carbohydrates. I have a diabetic patient who used to eat white rice every meal. Even if he ate vegetables strictly in accordance with the requirements of the Mediterranean diet, his blood lipids still could not be reduced. Later, he replaced half of the white rice with mixed beans and sweet potatoes, and his bad cholesterol dropped by 1.2mmol/L in half a year. But a word of caution, don’t go to extremes and engage in long-term ketosis. Many studies have now confirmed that long-term very low-carbohydrate ketogenic diet will increase the risk of cardiovascular disease, which is not worth the gain.

Oh, by the way, when it comes to food, we have to talk about the various heart-protecting supplements that everyone often asks about, such as coenzyme Q10, deep-sea fish oil, and Panax notoginseng powder. Are they really useful? Let me put it together: Coenzyme Q10 is currently only proven to be useful for two types of people. One type is patients with cardiomyopathy, and the other type is people who suffer from muscle soreness as a side effect of taking statins. Supplementation can indeed relieve symptoms. Healthy people take it without any additional heart-protecting effect, so don’t waste your money. As for deep-sea fish oil, only high-purity medicinal fish oil has a blood-lipid-lowering effect on patients with hypertriglyceridemia. Ordinary health-care fish oil has a pitifully low effective content and is basically useless. As for Chinese medicinal materials such as Panax notoginseng powder and Salvia miltiorrhiza, they do have the effect of promoting blood circulation and removing blood stasis, but they are not suitable for everyone. For example, people who are at risk of bleeding may have accidents if they eat them. It is best to ask a Chinese doctor before eating them, and do not eat them blindly.

After talking about food, let’s talk about exercise. HIIT has become really popular recently. Many people say that practicing HIIT for 10 minutes twice a week is more protective of the heart than running for an hour. This fact is actually quite controversial in the industry. One school of thought believes that for healthy young people with no underlying diseases, HIIT 1 to 2 times a week can indeed improve cardiopulmonary function faster and is more efficient than continuous moderate-intensity exercise. ； However, another group also clearly points out that patients with hypertension, coronary heart disease, and arrhythmia who do HIIT rashly can easily induce acute cardiovascular events, and the gains outweigh the losses. I once met a 28-year-old girl who never exercised. She practiced HIIT following videos on the Internet. Halfway through the training, her chest hurt and her eyesight turned black. She was sent to the emergency room to be diagnosed with sinus tachycardia, which took a long time to recover. In fact, for most ordinary people, there is no need to pursue any efficient exercise. Twenty to thirty minutes a day of brisk walking, Tai Chi, square dancing, and 150 minutes of moderate-intensity activity every week are enough. Even if you really can’t find time, going downstairs for a 10-minute walk after dinner, standing a few more times to collect water, and climbing two flights of stairs at work are much more useful than two hours of sudden exercise on weekends.

In fact, what is more important than eating and moving is to control your blood pressure, blood sugar, and blood lipids. These three are the number one culprits of cardiovascular disease. Many people think that they don’t need to care if they don’t have symptoms. This is really a big mistake. Last year, I treated a 42-year-old Internet executive who had high blood pressure for 3 years, with the highest blood pressure reaching 160/100mmHg. He felt that he could handle it at a young age and did not take any medicine. It was common for him to stay up late and socialize. However, he had an acute myocardial infarction during a meeting and had two stents inserted. Now he takes antihypertensive medicine every day and regrets it so much. Here is another point that is highly controversial: Many people think that antihypertensive drugs and lipid-lowering drugs are dependent on them. They cannot stop taking them and will not take them if they can. In fact, current mainstream guidelines believe that after high blood pressure is diagnosed, lifestyle adjustments should be made for three months. If it still cannot be lowered to the normal range, you must take medicine. People who control their blood pressure below 130/80mmHg for a long time have a risk of heart attack that is more than 40% lower than those who do not take medicine. Of course, there are a few newly discovered patients with mild hypertension who can stabilize their blood pressure within the normal range for a long time through weight loss, salt restriction, and exercise. They do not need to take medicine, but this must be evaluated by a doctor, and do not stop taking medicine casually.

There are a few other points that are easily overlooked by everyone, and I will mention them as well. The first is to quit smoking, including second-hand smoke, which is recognized as a cardiovascular killer. Smokers are twice as likely to have a heart attack as non-smokers. After quitting, within 10 years, the cardiovascular risk will be reduced to about the same as that of non-smokers. It is never too late to quit. Then there is drinking. Everyone used to say that drinking a small amount of red wine protects the heart. Now the latest global research has clearly overturned this conclusion. No matter how much wine you drink, even one sip, it will increase the risk of cardiovascular disease. Stop believing in the rumor that a glass of red wine every day protects the heart. There are also emotions. Long-term anxiety, stress, and staying up late can also increase the risk of cardiovascular disease. I have met several patients with acute myocardial infarction in their 20s who usually have normal blood pressure and blood lipids. However, they stayed up late and worked overtime for several months, and suffered from insomnia every day for a week before the onset of the disease. Of course, there is no need to be too anxious. It does not mean that you will get heart disease if you stay up late. Long-term chronic stress should be treated carefully. Take half a day every week to do something you like, such as fishing, shopping, and complaining about work with friends. It is more effective than any heart-protecting health products.

In fact, having said so much, you will find that there is really nothing mysterious about heart disease prevention. It is all small things that can be done every day. There is no need to pursue any perfect health plan, the best one is the one that suits you. If you are not sure about your risk, have a regular physical examination every year to check your blood pressure, blood lipids, blood sugar, and electrocardiogram. If you have an immediate family member who has had a myocardial infarction or cerebral infarction before the age of 50, it is best to get a cardiovascular risk screening in advance. It is always good to take more care. After all, your body is your own. It is better to pay more attention to it than to run to the hospital if something happens.